从外科角度探讨原发性醛固酮增多症的规范化诊疗

Standardized diagnosis and treatment of primary aldosteronism from a surgeon s perspective

原发性醛固酮增多症(简称原醛症)是继发性高血压最常见的病因,也是泌尿外科常遇到的肾上腺疾病.近年来,我国肾上腺源性高血压外科疾病的诊疗取得阶段性成果,但泌尿外科医生在原醛症的筛查、确诊、功能诊断和治疗过程中存在诸多不足.鉴于疾病的复杂性和全国各地医疗水平的参差不齐,泌尿外科医生迫切需要强化对原醛症诊疗规范的认识本文着重阐述泌尿外科医生在原醛症诊疗过程中遇到的常见问题,从流行病学、疾病筛查、多学科团队建设、肾上腺静脉采血、治疗策略等关键问题着手,重点阐述规范诊疗的原则,希望进一步提高我国肾上腺源性高血压外科疾病的诊疗水平.

Primary aldosterouisnm( PA ) is a subtype of adrenal diseases in urological department, which is the most common cause of secondary hypertension. In recent years, great improvements and achievements have been made in the field of diagnosis and treatment of adrenal hypertension in China, however, there are some insufficiencies in the process of screening, diagnosis, function diagnosis and treatment. Because of the disease complexity and different levels of health care among China, it' s necessary for urological doctors lo leiirn iibout the standarization of diagnosis and treatment of PA. This review gives emphasize on the common problems during the process of diagnosis and treatment of PA. We highlight the principle in skiiularization of diagnosis and treatment of PA by discussing epidemiology, screening, multidisciplinan team building, adrenal venous sampling and treatment strategy, hoping to improve clinical practice of adrenal hypertension in China.